Key result
Advance directive completion reaches 63% in high-risk surgical decedents but frequently occurs late in the illness trajectory.
Why the study?
High-risk patients undergoing elective surgery face perioperative complications including readmission and death, and advance care planning may allow preparation for such events.
What is the completion rate of advance directives and their association with one-year readmissions and mortality in high-risk patients undergoing elective surgery?
Population
400 patients undergoing preoperative evaluation for elective surgery at two hospitals in the United States
Comparison
Completion of advance directives vs non-completion
Design
Observational cohort study conducted through chart review
Follow-up
One year
Authors
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High-risk surgical patients often lack advance directives before readmission or death; leaves open whether preoperative planning improves timely completion.
Cohort (n=390)
Yes
What is the completion rate of advance directives and their association with one-year readmissions and mortality in high-risk patients undergoing elective surgery?
Absolute Event Rate: 63% vs 18%
p-value: p=<0.001
Preoperative clinics represent a missed opportunity for advance care planning in high-risk surgical patients, as many experience readmission or death without an advance directive.
Patel et al. (2021) conducted a cohort in High-risk patients undergoing elective surgery (n=390). Advance Directives (AD) vs. No Advance Directive was evaluated on Advance directive completion rate (decedents vs survivors) (p=<0.001). Among high-risk surgical patients, advance directive completion was significantly more common in those who died within one year compared to survivors (63% vs 18%, p<0.001), though often completed late in the illness trajectory.
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